1 Loading
## Loading and correcting outcome data from: C:/Users/risha/OneDrive/Desktop/NMA
## ✓ Loaded and corrected: TST - Studies: 10
## ✓ Loaded and corrected: SOL - Studies: 13
## ✓ Loaded and corrected: WASO - Studies: 10
## ✓ Loaded and corrected: PSQI - Studies: 8
## ✓ Loaded and corrected: SE - Studies: 10
2 Primary Analysis Summary
## Treatments found: Ashwagandha, Melatonin-IR, Melatonin-PR, Tart-cherry, Valerian
## Treatments to display: Melatonin-IR, Ashwagandha, Melatonin-PR, Valerian, Tart-cherry
Table 1: Primary Analysis Results - Mean Differences vs Placebo
|
|
MD vs Placebo (95% CrI)
|
|
Outcome
|
Studies
|
Patients
|
τ (95% CrI)
|
DIC
|
Melatonin-IR
|
Ashwagandha
|
Melatonin-PR
|
Valerian
|
Tart-cherry
|
|
TST ↑
|
10
|
725
|
3.801 (0.154-23.570)
|
NA
|
11.62 (-0.64 to 26.42)
|
10.61 (0.42 to 23.42)
|
6.96 (-8.04 to 21.65)
|
0.41 (-18.69 to 19.86)
|
28.93 (-3.89 to 62.94)
|
|
SOL ↓
|
13
|
1107
|
1.266 (0.055-6.276)
|
NA
|
-6.31 (-10.83 to -2.27)
|
-4.60 (-7.36 to -1.17)
|
-7.92 (-13.47 to -2.50)
|
-1.57 (-7.39 to 3.76)
|
-2.26 (-13.65 to 9.08)
|
|
WASO ↓
|
10
|
476
|
2.528 (0.383-12.346)
|
NA
|
-3.05 (-12.30 to 3.57)
|
-2.38 (-8.65 to 3.14)
|
-5.30 (-21.15 to 10.98)
|
-5.18 (-14.69 to 6.39)
|
-11.84 (-39.98 to 16.41)
|
|
PSQI ↓
|
8
|
1036
|
0.623 (0.129-2.309)
|
NA
|
-0.75 (-1.83 to 1.27)
|
-0.80 (-1.96 to 0.41)
|
-0.63 (-1.94 to 0.77)
|
-5.27 (-7.49 to -3.03)
|
NA
|
|
SE ↑
|
10
|
488
|
0.683 (0.033-3.132)
|
NA
|
3.01 (0.65 to 5.39)
|
2.99 (1.18 to 4.54)
|
3.37 (-1.43 to 8.14)
|
0.55 (-3.44 to 4.41)
|
2.47 (-2.66 to 7.70)
|
|
Note:
|
|
↑ = Higher values are better (TST, SE)
|
|
↓ = Lower values are better (SOL, WASO, PSQI)
|
|
τ = Between-study heterogeneity
|
|
DIC = Deviance Information Criterion
|
SUCRA Rankings
## Found pre-calculated SUCRA values for TST
## Found pre-calculated SUCRA values for SOL
## Found pre-calculated SUCRA values for WASO
## Found pre-calculated SUCRA values for PSQI
## Found pre-calculated SUCRA values for SE
Table 2: SUCRA Values (%) - Higher values indicate better ranking
|
Treatment
|
TST ↑
|
SOL ↓
|
WASO ↓
|
PSQI ↓
|
SE ↑
|
Mean_SUCRA
|
|
Tart-cherry
|
89.4
|
43.5
|
75.3
|
NA
|
56.1
|
66.1
|
|
Melatonin-IR
|
68.0
|
78.1
|
60.2
|
46.5
|
67.6
|
64.1
|
|
Ashwagandha
|
62.2
|
57.0
|
52.6
|
52.5
|
67.6
|
58.4
|
|
Melatonin-PR
|
45.4
|
87.7
|
17.3
|
42.8
|
69.6
|
52.5
|
|
Valerian
|
20.8
|
11.7
|
68.7
|
99.7
|
26.2
|
45.4
|
|
Placebo
|
14.2
|
22.1
|
25.8
|
8.6
|
12.9
|
16.7
|
2.22 DEBUG
## === DEBUGGING DATA STRUCTURE ===
## Examining structure for: TST
## Available analyses:
## [1] "base_case" "sens_rob"
## [3] "sens_design" "sens_prior"
## [5] "sens_corr_Primary r0.5" "sens_corr_Low correlation r0.2"
## [7] "sens_corr_High correlation r0.8" "sens_magnesium"
##
##
## Structure of base_case:
## [1] "outcome" "analysis" "n_studies"
## [4] "n_patients" "tau_median" "tau_lower"
## [7] "tau_upper" "dic" "effects_vs_placebo"
## [10] "sucra"
##
##
## Sample effects_vs_placebo:
## Placebo Ashwagandha Melatonin-IR
## "Placebo" "10.61 (0.42 to 23.42)" "11.62 (-0.64 to 26.42)"
##
##
## Looking for 'analysis' field in base_case:
## [1] "Base case"
4 SUCRA
## Found pre-calculated SUCRA values for TST
## Found pre-calculated SUCRA values for SOL
## Found pre-calculated SUCRA values for WASO
## Found pre-calculated SUCRA values for PSQI
## Found pre-calculated SUCRA values for SE
Table 2: SUCRA Values (%) - Higher values indicate better ranking
|
Treatment
|
TST ↑
|
SOL ↓
|
WASO ↓
|
PSQI ↓
|
SE ↑
|
Mean_SUCRA
|
|
Tart-cherry
|
89.4
|
43.5
|
75.3
|
NA
|
56.1
|
66.1
|
|
Melatonin-IR
|
68.0
|
78.1
|
60.2
|
46.5
|
67.6
|
64.1
|
|
Ashwagandha
|
62.2
|
57.0
|
52.6
|
52.5
|
67.6
|
58.4
|
|
Melatonin-PR
|
45.4
|
87.7
|
17.3
|
42.8
|
69.6
|
52.5
|
|
Valerian
|
20.8
|
11.7
|
68.7
|
99.7
|
26.2
|
45.4
|
|
Placebo
|
14.2
|
22.1
|
25.8
|
8.6
|
12.9
|
16.7
|
5 Treatment consistency
6 Heterogeneity
Table 4: Between-study Heterogeneity (τ)
|
|
Outcome
|
Tau
|
Lower
|
Upper
|
|
50%…1
|
TST
|
3.801
|
0.154
|
23.570
|
|
50%…2
|
SOL
|
1.266
|
0.055
|
6.276
|
|
50%…3
|
WASO
|
2.528
|
0.383
|
12.346
|
|
50%…4
|
PSQI
|
0.623
|
0.129
|
2.309
|
|
50%…5
|
SE
|
0.683
|
0.033
|
3.132
|
7 Best treatment by outcome
## Debug: Available outcomes in sucra_comparison: TST, SOL, WASO, PSQI, SE
## Debug: Number of rows: 29
##
## Debug: best_per_outcome dimensions: 15 x 5
## Debug: Column names: Outcome, Rank, Treatment, SUCRA, Interpretation
##
##
## ### Top treatments for PSQI
##
## Debug: Data for PSQI - Rows: 3
## <table class="table table-striped" style="width: auto !important; margin-left: auto; margin-right: auto;">
## <caption>PSQI: Reduced sleep disturbance</caption>
## <thead>
## <tr>
## <th style="text-align:center;"> Rank </th>
## <th style="text-align:left;"> Treatment </th>
## <th style="text-align:center;"> SUCRA % </th>
## <th style="text-align:left;"> Clinical Benefit </th>
## </tr>
## </thead>
## <tbody>
## <tr>
## <td style="text-align:center;font-weight: bold;color: darkgreen !important;"> 1 </td>
## <td style="text-align:left;font-weight: bold;color: darkgreen !important;"> Valerian </td>
## <td style="text-align:center;font-weight: bold;color: darkgreen !important;"> 99.7 </td>
## <td style="text-align:left;font-weight: bold;color: darkgreen !important;"> Reduced sleep disturbance </td>
## </tr>
## <tr>
## <td style="text-align:center;"> 2 </td>
## <td style="text-align:left;"> Ashwagandha </td>
## <td style="text-align:center;"> 52.5 </td>
## <td style="text-align:left;"> Reduced sleep disturbance </td>
## </tr>
## <tr>
## <td style="text-align:center;"> 3 </td>
## <td style="text-align:left;"> Melatonin-IR </td>
## <td style="text-align:center;"> 46.5 </td>
## <td style="text-align:left;"> Reduced sleep disturbance </td>
## </tr>
## </tbody>
## </table>
##
## ### Top treatments for SE
##
## Debug: Data for SE - Rows: 3
## <table class="table table-striped" style="width: auto !important; margin-left: auto; margin-right: auto;">
## <caption>SE: Increased sleep efficiency</caption>
## <thead>
## <tr>
## <th style="text-align:center;"> Rank </th>
## <th style="text-align:left;"> Treatment </th>
## <th style="text-align:center;"> SUCRA % </th>
## <th style="text-align:left;"> Clinical Benefit </th>
## </tr>
## </thead>
## <tbody>
## <tr>
## <td style="text-align:center;font-weight: bold;color: darkgreen !important;"> 1 </td>
## <td style="text-align:left;font-weight: bold;color: darkgreen !important;"> Melatonin-PR </td>
## <td style="text-align:center;font-weight: bold;color: darkgreen !important;"> 69.6 </td>
## <td style="text-align:left;font-weight: bold;color: darkgreen !important;"> Increased sleep efficiency </td>
## </tr>
## <tr>
## <td style="text-align:center;"> 2 </td>
## <td style="text-align:left;"> Melatonin-IR </td>
## <td style="text-align:center;"> 67.6 </td>
## <td style="text-align:left;"> Increased sleep efficiency </td>
## </tr>
## <tr>
## <td style="text-align:center;"> 3 </td>
## <td style="text-align:left;"> Ashwagandha </td>
## <td style="text-align:center;"> 67.6 </td>
## <td style="text-align:left;"> Increased sleep efficiency </td>
## </tr>
## </tbody>
## </table>
##
## ### Top treatments for SOL
##
## Debug: Data for SOL - Rows: 3
## <table class="table table-striped" style="width: auto !important; margin-left: auto; margin-right: auto;">
## <caption>SOL: Reduced sleep onset latency</caption>
## <thead>
## <tr>
## <th style="text-align:center;"> Rank </th>
## <th style="text-align:left;"> Treatment </th>
## <th style="text-align:center;"> SUCRA % </th>
## <th style="text-align:left;"> Clinical Benefit </th>
## </tr>
## </thead>
## <tbody>
## <tr>
## <td style="text-align:center;font-weight: bold;color: darkgreen !important;"> 1 </td>
## <td style="text-align:left;font-weight: bold;color: darkgreen !important;"> Melatonin-PR </td>
## <td style="text-align:center;font-weight: bold;color: darkgreen !important;"> 87.7 </td>
## <td style="text-align:left;font-weight: bold;color: darkgreen !important;"> Reduced sleep onset latency </td>
## </tr>
## <tr>
## <td style="text-align:center;"> 2 </td>
## <td style="text-align:left;"> Melatonin-IR </td>
## <td style="text-align:center;"> 78.1 </td>
## <td style="text-align:left;"> Reduced sleep onset latency </td>
## </tr>
## <tr>
## <td style="text-align:center;"> 3 </td>
## <td style="text-align:left;"> Ashwagandha </td>
## <td style="text-align:center;"> 57.0 </td>
## <td style="text-align:left;"> Reduced sleep onset latency </td>
## </tr>
## </tbody>
## </table>
##
## ### Top treatments for TST
##
## Debug: Data for TST - Rows: 3
## <table class="table table-striped" style="width: auto !important; margin-left: auto; margin-right: auto;">
## <caption>TST: Increased total sleep time</caption>
## <thead>
## <tr>
## <th style="text-align:center;"> Rank </th>
## <th style="text-align:left;"> Treatment </th>
## <th style="text-align:center;"> SUCRA % </th>
## <th style="text-align:left;"> Clinical Benefit </th>
## </tr>
## </thead>
## <tbody>
## <tr>
## <td style="text-align:center;font-weight: bold;color: darkgreen !important;"> 1 </td>
## <td style="text-align:left;font-weight: bold;color: darkgreen !important;"> Tart-cherry </td>
## <td style="text-align:center;font-weight: bold;color: darkgreen !important;"> 89.4 </td>
## <td style="text-align:left;font-weight: bold;color: darkgreen !important;"> Increased total sleep time </td>
## </tr>
## <tr>
## <td style="text-align:center;"> 2 </td>
## <td style="text-align:left;"> Melatonin-IR </td>
## <td style="text-align:center;"> 68.0 </td>
## <td style="text-align:left;"> Increased total sleep time </td>
## </tr>
## <tr>
## <td style="text-align:center;"> 3 </td>
## <td style="text-align:left;"> Ashwagandha </td>
## <td style="text-align:center;"> 62.2 </td>
## <td style="text-align:left;"> Increased total sleep time </td>
## </tr>
## </tbody>
## </table>
##
## ### Top treatments for WASO
##
## Debug: Data for WASO - Rows: 3
## <table class="table table-striped" style="width: auto !important; margin-left: auto; margin-right: auto;">
## <caption>WASO: Reduced wake after sleep onset</caption>
## <thead>
## <tr>
## <th style="text-align:center;"> Rank </th>
## <th style="text-align:left;"> Treatment </th>
## <th style="text-align:center;"> SUCRA % </th>
## <th style="text-align:left;"> Clinical Benefit </th>
## </tr>
## </thead>
## <tbody>
## <tr>
## <td style="text-align:center;font-weight: bold;color: darkgreen !important;"> 1 </td>
## <td style="text-align:left;font-weight: bold;color: darkgreen !important;"> Tart-cherry </td>
## <td style="text-align:center;font-weight: bold;color: darkgreen !important;"> 75.3 </td>
## <td style="text-align:left;font-weight: bold;color: darkgreen !important;"> Reduced wake after sleep onset </td>
## </tr>
## <tr>
## <td style="text-align:center;"> 2 </td>
## <td style="text-align:left;"> Valerian </td>
## <td style="text-align:center;"> 68.7 </td>
## <td style="text-align:left;"> Reduced wake after sleep onset </td>
## </tr>
## <tr>
## <td style="text-align:center;"> 3 </td>
## <td style="text-align:left;"> Melatonin-IR </td>
## <td style="text-align:center;"> 60.2 </td>
## <td style="text-align:left;"> Reduced wake after sleep onset </td>
## </tr>
## </tbody>
## </table>
##
## ### Overall Best Performers
##
## <table class="table table-striped table-hover" style="width: auto !important; margin-left: auto; margin-right: auto;">
## <caption>Best Treatment for Each Outcome</caption>
## <thead>
## <tr>
## <th style="text-align:left;"> Outcome </th>
## <th style="text-align:left;"> Best Treatment </th>
## <th style="text-align:center;"> SUCRA % </th>
## <th style="text-align:left;"> Clinical Benefit </th>
## </tr>
## </thead>
## <tbody>
## <tr>
## <td style="text-align:left;"> PSQI </td>
## <td style="text-align:left;"> Valerian </td>
## <td style="text-align:center;"> 99.7 </td>
## <td style="text-align:left;"> Reduced sleep disturbance </td>
## </tr>
## <tr>
## <td style="text-align:left;"> SE </td>
## <td style="text-align:left;"> Melatonin-PR </td>
## <td style="text-align:center;"> 69.6 </td>
## <td style="text-align:left;"> Increased sleep efficiency </td>
## </tr>
## <tr>
## <td style="text-align:left;"> SOL </td>
## <td style="text-align:left;"> Melatonin-PR </td>
## <td style="text-align:center;"> 87.7 </td>
## <td style="text-align:left;"> Reduced sleep onset latency </td>
## </tr>
## <tr>
## <td style="text-align:left;"> TST </td>
## <td style="text-align:left;"> Tart-cherry </td>
## <td style="text-align:center;"> 89.4 </td>
## <td style="text-align:left;"> Increased total sleep time </td>
## </tr>
## <tr>
## <td style="text-align:left;"> WASO </td>
## <td style="text-align:left;"> Tart-cherry </td>
## <td style="text-align:center;"> 75.3 </td>
## <td style="text-align:left;"> Reduced wake after sleep onset </td>
## </tr>
## </tbody>
## </table>
8 Summary
## ## Analysis Summary
## **Outcomes analyzed:** TST, SOL, WASO, PSQI, SE
## **Most consistent performer:** Tart-cherry
## - Mean SUCRA: 66.1%
## - Consistency (CV): 30.8%
## - Effective in 4/5 outcomes
##
## **Average heterogeneity (τ):** 1.780
## - Interpretation: High heterogeneity across outcomes
##
## ## Key Findings
## 1. **Treatment Efficacy:** Based on SUCRA rankings, the most effective treatments overall are:
## 1. Tart-cherry (Mean SUCRA: 66.1%)
## 2. Melatonin-IR (Mean SUCRA: 64.1%)
## 3. Ashwagandha (Mean SUCRA: 58.4%)
##
## 2. **Outcome-Specific Recommendations:**
## - PSQI: Valerian (SUCRA: 99.7%)
## - SE: Melatonin-PR (SUCRA: 69.6%)
## - SOL: Melatonin-PR (SUCRA: 87.7%)
## - TST: Tart-cherry (SUCRA: 89.4%)
## - WASO: Tart-cherry (SUCRA: 75.3%)
##
## 3. **Consistency of Evidence:**
## The following treatments showed consistent performance (CV < 30%):
## - Melatonin-IR, Ashwagandha
##
## **Results saved to:** C:/Users/risha/OneDrive/Desktop/NMA/consolidated_results.rds
9 APPENDIX
## ## Sensitivity Analysis Coverage
## ### TST
## Analyses performed: base_case, sens_rob, sens_design, sens_prior, sens_corr_Primary r0.5, sens_corr_Low correlation r0.2, sens_corr_High correlation r0.8, sens_magnesium
##
## - base_case: 10 studies, 725 patients
## - sens_rob: 10 studies, 725 patients
## - sens_design: 6 studies, 619 patients
## - sens_prior: 10 studies, 725 patients
## - sens_corr_Primary r0.5: 10 studies, 725 patients
## - sens_corr_Low correlation r0.2: 10 studies, 725 patients
## - sens_corr_High correlation r0.8: 10 studies, 725 patients
## - sens_magnesium: 11 studies, 768 patients
##
## ### SOL
## Analyses performed: base_case, sens_rob, sens_design, sens_prior, sens_corr_Primary r0.5, sens_corr_Low correlation r0.2, sens_corr_High correlation r0.8, sens_magnesium
##
## - base_case: 13 studies, 1107 patients
## - sens_rob: 13 studies, 1107 patients
## - sens_design: 7 studies, 953 patients
## - sens_prior: 13 studies, 1107 patients
## - sens_corr_Primary r0.5: 13 studies, 1107 patients
## - sens_corr_Low correlation r0.2: 13 studies, 1107 patients
## - sens_corr_High correlation r0.8: 13 studies, 1107 patients
## - sens_magnesium: 14 studies, 1150 patients
##
## ### WASO
## Analyses performed: base_case, sens_rob, sens_design, sens_prior, sens_corr_Primary r0.5, sens_corr_Low correlation r0.2, sens_corr_High correlation r0.8
##
## - base_case: 10 studies, 476 patients
## - sens_rob: 10 studies, 476 patients
## - sens_design: 5 studies, 338 patients
## - sens_prior: 10 studies, 476 patients
## - sens_corr_Primary r0.5: 10 studies, 476 patients
## - sens_corr_Low correlation r0.2: 10 studies, 476 patients
## - sens_corr_High correlation r0.8: 10 studies, 476 patients
##
## ### PSQI
## Analyses performed: base_case, sens_rob, sens_design, sens_prior, sens_corr_Primary r0.5, sens_corr_Low correlation r0.2, sens_corr_High correlation r0.8
##
## - base_case: 8 studies, 1036 patients
## - sens_rob: 8 studies, 1036 patients
## - sens_design: 8 studies, 1036 patients
## - sens_prior: 8 studies, 1036 patients
## - sens_corr_Primary r0.5: 8 studies, 1036 patients
## - sens_corr_Low correlation r0.2: 8 studies, 1036 patients
## - sens_corr_High correlation r0.8: 8 studies, 1036 patients
##
## ### SE
## Analyses performed: base_case, sens_rob, sens_design, sens_prior, sens_corr_Primary r0.5, sens_corr_Low correlation r0.2, sens_corr_High correlation r0.8, sens_magnesium
##
## - base_case: 10 studies, 488 patients
## - sens_rob: 10 studies, 488 patients
## - sens_design: 4 studies, 298 patients
## - sens_prior: 10 studies, 488 patients
## - sens_corr_Primary r0.5: 10 studies, 488 patients
## - sens_corr_Low correlation r0.2: 10 studies, 488 patients
## - sens_corr_High correlation r0.8: 10 studies, 488 patients
## - sens_magnesium: 11 studies, 531 patients
##
## ## Session Information
## R version 4.5.1 (2025-06-13 ucrt)
## Platform: x86_64-w64-mingw32/x64
## Running under: Windows 11 x64 (build 26100)
##
## Matrix products: default
## LAPACK version 3.12.1
##
## locale:
## [1] LC_COLLATE=English_United Kingdom.utf8
## [2] LC_CTYPE=English_United Kingdom.utf8
## [3] LC_MONETARY=English_United Kingdom.utf8
## [4] LC_NUMERIC=C
## [5] LC_TIME=English_United Kingdom.utf8
##
## time zone: Europe/London
## tzcode source: internal
##
## attached base packages:
## [1] stats graphics grDevices utils datasets methods base
##
## other attached packages:
## [1] patchwork_1.3.1 gridExtra_2.3 kableExtra_1.4.0 lubridate_1.9.4
## [5] forcats_1.0.0 stringr_1.5.1 dplyr_1.1.4 purrr_1.1.0
## [9] readr_2.1.5 tidyr_1.3.1 tibble_3.3.0 ggplot2_3.5.2
## [13] tidyverse_2.0.0
##
## loaded via a namespace (and not attached):
## [1] gtable_0.3.6 jsonlite_2.0.0 compiler_4.5.1 tidyselect_1.2.1
## [5] xml2_1.3.8 jquerylib_0.1.4 textshaping_1.0.1 systemfonts_1.2.3
## [9] scales_1.4.0 yaml_2.3.10 fastmap_1.2.0 R6_2.6.1
## [13] labeling_0.4.3 generics_0.1.4 knitr_1.50 svglite_2.2.1
## [17] bslib_0.9.0 pillar_1.11.0 RColorBrewer_1.1-3 tzdb_0.5.0
## [21] rlang_1.1.6 cachem_1.1.0 stringi_1.8.7 xfun_0.52
## [25] sass_0.4.10 viridisLite_0.4.2 timechange_0.3.0 cli_3.6.5
## [29] withr_3.0.2 magrittr_2.0.3 digest_0.6.37 grid_4.5.1
## [33] rstudioapi_0.17.1 hms_1.1.3 lifecycle_1.0.4 vctrs_0.6.5
## [37] evaluate_1.0.4 glue_1.8.0 farver_2.1.2 rmarkdown_2.29
## [41] tools_4.5.1 pkgconfig_2.0.3 htmltools_0.5.8.1
